How to perform extracorporeal photopheresis via port catheter.

BACKGROUND: Extracorporeal photopheresis (ECP) is commonly performed via peripheral venous access catheter. If this is not possible, a tunneled central venous catheter may be considered. However, this access mode may be associated with high complication rates. Port catheters and permanent arteriovenous fistulas in principle could serve as alternative options; however, treatment opinions are limited.

STUDY DESIGN AND METHODS: We report on four adult patients with poor peripheral vein conditions in whom we performed ECP via port catheter.

RESULTS: In three of four patients, problems arising from temporarily impaired blood aspiration or reinfusion were solved by repositioning the patient, intermittent flushing of the port catheter, and, in one patient, by instillation of 2500 units of heparin into the port prior to the first ECP of the 2-day cycle. One female patient sustained extensive central venous thrombosis.

CONCLUSION: A port catheter may, in certain circumstances, constitute a patient-friendly alternative for venous ECP access when patients' peripheral veins are unsuitable. However, a prolonged ECP procedure duration must be taken into account for decision making.